Advances in Open Reduction and Internal Fixation of Multiple Mandibular Fractures with Condylar Involvement.

Multiple mandibular fractures with condylar involvement are challenging to treat. This article presents a series of steps to simplify the treatment and improve the outcomes in open reduction and internal fixation of multiple mandibular fractures with condylar involvement. Four new elements are identified: three-dimensional printing, model surgery, Kirschner wires to manipulate the segments in condylar fractures, and a top-to-bottom sequence. This algorithm has contributed to streamlining the procedure and improving the outcomes of these challenging fractures. For the same operator, reduction and osteosynthesis require approximately 40 minutes less than before the adoption of the new protocol. The authors have not encountered suboptimal reductions or situations where the screws were too long, necessitating exchange for shorter ones in revision surgery.